Ultrasonic surgical instrument with blade replacement features

ABSTRACT

An apparatus includes a shaft assembly and an end effector. The shaft assembly includes a first coupling member and a second coupling member. The first coupling member and the second coupling member are configured to flex toward each other from a first position to a second position. The first coupling member and the second coupling member define a pivot axis in the first position. The end effector includes an ultrasonic blade and a clamp arm. The clamp arm is configured to couple or decouple with the shaft assembly when the first coupling member and the second coupling member are in the second position. The clamp arm is configured to pivot toward and away the ultrasonic blade about the pivot axis when the first coupling member and the second coupling member are in the first position.

BACKGROUND

A variety of surgical instruments include an end effector having a bladeelement that vibrates at ultrasonic frequencies to cut and/or sealtissue (e.g., by denaturing proteins in tissue cells). These instrumentsinclude one or more piezoelectric elements that convert electrical powerinto ultrasonic vibrations, which are communicated along an acousticwaveguide to the blade element. The precision of cutting and coagulationmay be controlled by the operator's technique and adjusting the powerlevel, blade edge angle, tissue traction, and blade pressure.

Examples of ultrasonic surgical instruments include the HARMONIC ACE®Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONICFOCUS® Ultrasonic Shears, and the HARMONIC SYNERGY® Ultrasonic Blades,all by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Further examplesof such devices and related concepts are disclosed in U.S. Pat. No.5,322,055, entitled “Clamp Coagulator/Cutting System for UltrasonicSurgical Instruments,” issued Jun. 21, 1994, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 5,873,873, entitled“Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Mechanism,”issued Feb. 23, 1999, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 5,980,510, entitled “Ultrasonic ClampCoagulator Apparatus Having Improved Clamp Arm Pivot Mount,” issued Nov.9, 1999, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,283,981, entitled “Method of Balancing AsymmetricUltrasonic Surgical Blades,” issued Sep. 4, 2001, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 6,309,400,entitled “Curved Ultrasonic Blade having a Trapezoidal Cross Section,”issued Oct. 30, 2001, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 6,325,811, entitled “Blades withFunctional Balance Asymmetries for use with Ultrasonic SurgicalInstruments,” issued Dec. 4, 2001, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,423,082, entitled“Ultrasonic Surgical Blade with Improved Cutting and CoagulationFeatures,” issued Jul. 23, 2002, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 6,773,444, entitled “Blades withFunctional Balance Asymmetries for Use with Ultrasonic SurgicalInstruments,” issued Aug. 10, 2004, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,783,524, entitled“Robotic Surgical Tool with Ultrasound Cauterizing and CuttingInstrument,” issued Aug. 31, 2004, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,057,498, entitled“Ultrasonic Surgical Instrument Blades,” issued Nov. 15, 2011, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.8,461,744, entitled “Rotating Transducer Mount for Ultrasonic SurgicalInstruments,” issued Jun. 11, 2013, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,591,536, entitled“Ultrasonic Surgical Instrument Blades,” issued Nov. 26, 2013, thedisclosure of which is incorporated by reference herein; and U.S. Pat.No. 8,623,027, entitled “Ergonomic Surgical Instruments,” issued Jan. 7,2014, the disclosure of which is incorporated by reference herein.

Still further examples of ultrasonic surgical instruments are disclosedin U.S. Pub. No. 2006/0079874, entitled “Tissue Pad for Use with anUltrasonic Surgical Instrument,” published Apr. 13, 2006, the disclosureof which is incorporated by reference herein; U.S. Pub. No.2007/0191713, entitled “Ultrasonic Device for Cutting and Coagulating,”published Aug. 16, 2007, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2007/0282333, entitled “UltrasonicWaveguide and Blade,” published Dec. 6, 2007, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2008/0200940, entitled“Ultrasonic Device for Cutting and Coagulating,” published Aug. 21,2008, the disclosure of which is incorporated by reference herein; U.S.Pub. No. 2008/0234710, entitled “Ultrasonic Surgical Instruments,”published Sep. 25, 2008, the disclosure of which is incorporated byreference herein; and U.S. Pub. No. 2010/0069940, entitled “UltrasonicDevice for Fingertip Control,” published Mar. 18, 2010, the disclosureof which is incorporated by reference herein.

Some ultrasonic surgical instruments may include a cordless transducersuch as that disclosed in U.S. Pub. No. 2012/0112687, entitled “RechargeSystem for Medical Devices,” published May 10, 2012, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2012/0116265,entitled “Surgical Instrument with Charging Devices,” published May 10,2012, the disclosure of which is incorporated by reference herein;and/or U.S. Pat. App. No. 61/410,603, filed Nov. 5, 2010, entitled“Energy-Based Surgical Instruments,” the disclosure of which isincorporated by reference herein.

Additionally, some ultrasonic surgical instruments may include anarticulating shaft section. Examples of such ultrasonic surgicalinstruments are disclosed in U.S. Pub. No. 2014/0005701, published Jan.2, 2014, entitled “Surgical Instruments with Articulating Shafts,” thedisclosure of which is incorporated by reference herein; and U.S. Pub.No. 2014/0114334, published Apr. 24, 2014, entitled “Flexible HarmonicWaveguides/Blades for Surgical Instruments,” the disclosure of which isincorporated by reference herein.

While several surgical instruments and systems have been made and used,it is believed that no one prior to the inventors has made or used theinvention described in the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim this technology, it is believed this technologywill be better understood from the following description of certainexamples taken in conjunction with the accompanying drawings, in whichlike reference numerals identify the same elements and in which:

FIG. 1 depicts a side elevational view of an exemplary ultrasonicsurgical instrument;

FIG. 2 depicts a perspective view of the instrument of FIG. 1;

FIG. 3 depicts a perspective view of the instrument of FIG. 1, with adisposable portion separated from a reusable portion;

FIG. 4 depicts a perspective view of an end effector of the instrumentof FIG. 1, in an open configuration;

FIG. 5 depicts a partially exploded view of the end effector of FIG. 4;

FIG. 6A depicts a side elevational view of the end effector of FIG. 4,in the open configuration;

FIG. 6B depicts a side elevational view of the end effector of FIG. 4,in a closed configuration;

FIG. 7 depicts a side cross-sectional view of the end effector of FIG.4, in the open configuration;

FIG. 8A depicts a perspective view of an alternative end effector and analternative shaft assembly that may be readily incorporated into theinstrument of FIG. 1, where the end effector is in the open position;

FIG. 8B depicts a perspective view of the end effector and shaftassembly of FIG. 8A, where the end effector is in the closed position;

FIG. 9 depicts an exploded perspective view of the end effector andshaft assembly of FIG. 8A;

FIG. 10A depicts front cross-sectional view of the end effector of FIG.8A, where the clamp arm is detached from the inner and outer tube of theshaft assembly;

FIG. 10B depicts a front cross-sectional view of the end effector ofFIG. 8A, where the clamp arm is detached from the inner and outer tubeof the shaft assembly, where the distal prongs of the inner tube arepressed toward each other;

FIG. 10C depicts a front cross-sectional view of the end effector ofFIG. 8A, where the clamp arm is attached to the inner and outer tube ofthe shaft assembly, where the distal prongs of the inner tube arepressed toward each other;

FIG. 10D depicts a front cross-sectional view of the end effector ofFIG. 8A, where the clamp arm is attached to the inner and outer tube ofthe shaft assembly, where the distal prongs of the inner tube engage theintegral pins of the clamp arm;

FIG. 10E depicts a front cross-sectional view of the end effector ofFIG. 8A completely assembled;

FIG. 11A depicts a perspective view of an another alternative endeffector and an another alternative shaft assembly that may be readilyincorporated into the instrument of FIG. 1, where the end effector is inthe open position;

FIG. 11B depicts a perspective view of the end effector and shaftassembly of FIG. 11A, where the end effector is in the closed position;

FIG. 12A depicts a top elevational view of the end effector and shaftassembly of FIG. 11A, where the clamp arm is detached from the inner andouter tube;

FIG. 12B depicts a top elevational view of the end effector and shaftassembly of FIG. 11A, where the clamp arm is detached from the inner andouter tube, where the distal prongs of the inner tube are pressed towardeach other;

FIG. 12C depicts a top elevational view of the end effector and shaftassembly of FIG. 11A, where the clamp arm is in the open position andattached to the inner and outer tube, where the distal prongs of theinner tube are pressed toward each other;

FIG. 12D depicts a top elevational view of the end effector and shaftassembly of FIG. 11A, where the clamp arm is in the open position andattached to the inner and outer tube, where the distal prongs of theinner tube engage the integral pins of the clamp arm;

FIG. 12E depicts a top elevational view of the end effector and shaftassembly of FIG. 11A, where the clamp arm is in the closed position andattached to the inner and outer tube;

FIG. 13A depicts a perspective view of another alternative end effectorand alternative shaft assembly that may be readily incorporated into theinstrument of FIG. 1, where the end effector is in the open position;

FIG. 13B depicts a perspective view of the end effector and shaftassembly of FIG. 13A, where the end effector is in the closed position;

FIG. 14A depicts a partial cross-sectional perspective view of the endeffector and shaft assembly of FIG. 13A, where the end effector is inthe open position, where the removable clip is removed from the distalprongs of the inner tube;

FIG. 14B depicts a partial cross-sectional perspective view of the endeffector and shaft assembly of FIG. 13A, where the end effector is inthe open position, where the removable clip is partially inserted inbetween the distal prongs of the inner tube;

FIG. 14C depicts a partial cross-sectional perspective view of the endeffector and shaft assembly of FIG. 13A, where the end effector is inthe open position, where the removable clip is completely inserted inbetween the distal prongs of the inner tube;

FIG. 15A depicts a side cross-sectional view of an alternative shaftassembly that may be readily incorporated into the instrument of FIG. 1,where a spring loaded key lock is in a closed position;

FIG. 15B depicts a side cross-sectional view of the shaft assembly ofFIG. 15A, where the spring loaded key lock is in an open position;

FIG. 16A depicts a cross-sectional view of the shaft assembly of FIG.15A, taken along line 16A-16A of FIG. 15A, where the spring loaded keylock is in the closed position;

FIG. 16B depicts a cross-sectional view of the shaft assembly of FIG.15A, taken along line 16B-16B of FIG. 15B, where the spring loaded keylock is in the open position;

FIG. 17 depicts an exploded side view of another alternative shaftassembly that may be readily incorporated into the instrument of FIG. 1.

FIG. 18A depicts a partial side cross-sectional view of the shaftassembly of FIG. 17, where the waveguide is in a proximal position;

FIG. 18B depicts a partial side cross-sectional view of the shaftassembly of FIG. 17, where the waveguide is in a distal position;

FIG. 18C depicts a partial side cross-sectional view of the shaftassembly of FIG. 17, where the waveguide is in the distal position andlocked relative to the rotation assembly;

FIG. 19 depicts a side cross-sectional view of an alternative waveguidewith a clocking pin and an alternative disposable body that may bereadily incorporated into the instrument of FIG. 1;

FIG. 20 depicts a top plan view of the waveguide of FIG. 19;

FIG. 21 depicts a side elevational view of the waveguide of FIG. 19;

FIG. 22 depicts a perspective view of the clocking pin of FIG. 19;

FIG. 23 depicts a top plan view of the waveguide and clocking pin ofFIG. 19;

FIG. 24 depicts a side elevational view of the waveguide and clockingpin of FIG. 19;

FIG. 25A depicts a cross-sectional side view of the waveguide andclocking pin of FIG. 19 being initially inserted into a threaded shroudof the disposable assembly of FIG. 19;

FIG. 25B depicts a cross-sectional side view of the waveguide andclocking pin of FIG. 19 being further rotated into the threaded shroudof the disposable assembly of FIG. 19;

FIG. 25C depicts a cross-sectional side view of the waveguide andclocking pin of FIG. 19 being locked into the threaded shroud of thedisposable assembly of FIG. 19;

FIG. 26A depicts a cross-sectional view, taken along line 26A-26A ofFIG. 25A, of the waveguide and clocking pin of FIG. 19 being initiallyinserted into the threaded shroud of disposable assembly of FIG. 19;

FIG. 26B depicts a cross-sectional view, taken along line 26B-26B ofFIG. 25B, of the waveguide and clocking pin of FIG. 19 being initiallyinserted into the threaded shroud of disposable assembly of FIG. 19;

FIG. 26C depicts a cross-sectional view, taken along line 26C-26C ofFIG. 25C, of the waveguide and clocking pin of FIG. 19 being locked intothe threaded shroud of the disposable assembly of FIG. 19;

FIG. 27A depicts a side cross-sectional view of another alternativeshaft assembly and disposable assembly that may be readily incorporatedinto the instrument of FIG. 1; and

FIG. 27B depicts a side cross-sectional view of the shaft assembly ofdisposable assembly of FIG. 27A, where the acoustic waveguide is removedfrom the rest of the shaft assembly but remains tethered.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the technology may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presenttechnology, and together with the description serve to explain theprinciples of the technology; it being understood, however, that thistechnology is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the technology shouldnot be used to limit its scope. Other examples, features, aspects,embodiments, and advantages of the technology will become apparent tothose skilled in the art from the following description, which is by wayof illustration, one of the best modes contemplated for carrying out thetechnology. As will be realized, the technology described herein iscapable of other different and obvious aspects, all without departingfrom the technology. Accordingly, the drawings and descriptions shouldbe regarded as illustrative in nature and not restrictive.

It is further understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

For clarity of disclosure, the terms “proximal” and “distal” are definedherein relative to a human or robotic operator of the surgicalinstrument. The term “proximal” refers the position of an element closerto the human or robotic operator of the surgical instrument and furtheraway from the surgical end effector of the surgical instrument. The term“distal” refers to the position of an element closer to the surgical endeffector of the surgical instrument and further away from the human orrobotic operator of the surgical instrument.

I. Overview of Exemplary Ultrasonic Surgical Instrument

FIGS. 1-3 show an exemplary ultrasonic surgical instrument (10) that isconfigured to be used in minimally invasive surgical procedures (e.g.,via a trocar or other small diameter access port, etc.). As will bedescribed in greater detail below, instrument (10) is operable to cuttissue and seal or weld tissue (e.g., a blood vessel, etc.)substantially simultaneously. Instrument (10) of this example comprisesa disposable assembly (100) and a reusable assembly (200). The distalportion of reusable assembly (200) is configured to removably receivethe proximal portion of disposable assembly (100), as seen in FIGS. 2-3,to form instrument (10).

In an exemplary use, assemblies (100, 200) are coupled together to forminstrument (10) before a surgical procedure, the assembled instrument(10) is used to perform the surgical procedure, and then assemblies(100, 200) are decoupled from each other for further processing. In someinstances, after the surgical procedure is complete, disposable assembly(100) is immediately disposed of while reusable assembly (200) issterilized and otherwise processed for re-use. By way of example only,reusable assembly (200) may be sterilized in a conventional relativelylow temperature, relatively low pressure, hydrogen peroxidesterilization process. Alternatively, reusable assembly (200) may besterilized using any other suitable systems and techniques (e.g.,autoclave, etc.). In some versions, reusable assembly (200) may besterilized and reused approximately 100 times. Alternatively, reusableassembly (200) may be subject to any other suitable life cycle. Forinstance, reusable assembly (200) may be disposed of after a single use,if desired. While disposable assembly (100) is referred to herein asbeing “disposable,” it should be understood that, in some instances,disposable assembly (100) may also be sterilized and otherwise processedfor re-use. By way of example only, disposable assembly (100) may besterilized and reused approximately 2-30 times, using any suitablesystems and techniques. Alternatively, disposable assembly (100) may besubject to any other suitable life cycle.

Disposable assembly (100) of the present example comprises a bodyportion (110), a shaft assembly (150) extending distally from bodyportion (110), and an end effector (180) located at the distal end ofshaft assembly (150). As best seen in FIGS. 4-7, end effector (180) ofthis example comprises a clamp arm (182) and an ultrasonic blade (190).Clamp arm (182) includes a clamp pad (184), which faces blade (190). Asshown in FIGS. 6A-6B, clamp arm (182) is pivotable toward and away fromblade (190) to selectively compress tissue between clamp pad (184) andblade (190). As seen in FIG. 7, blade (190) is an integral feature ofthe distal end of an acoustic waveguide (192), which extends coaxiallythrough tubes (152, 170), and which is configured to communicateultrasonic vibrations to blade (190).

Shaft assembly (150) comprises an outer tube (152) and an inner tube(170). Outer tube (152) is operable to translate longitudinally relativeto inner tube (170) to selectively pivot clamp arm (182) toward and awayfrom blade (190). To accomplish this, and as best seen in FIGS. 5 and 7,integral pin features (186) of clamp arm (182) pivotally secure a firstportion of clamp arm (182) to a distally projecting tongue (154) ofouter tube (152); while an inserted pin (188) pivotally secures a secondportion of clamp arm (182) to a distally projecting tongue (172) ofinner tube (170). Thus, as can be seen in the transition from FIG. 6A toFIG. 6B, tubes (152, 170) cooperate to pivot clamp arm (182) towardblade (190) when outer tube (152) is retracted proximally relative toinner tube (170). It should be understood that clamp arm (182) may bepivoted back away from blade (190) (e.g., from the position shown inFIG. 6B to the position shown in FIG. 6A) by translating outer tube(152) distally relative to inner tube (170), in reverse of the operationshown in FIGS. 6A-6B. In an exemplary use, clamp arm (182) may bepivoted toward blade (190) to grasp, compress, seal, and sever tissuecaptured between clamp pad (184) and blade (190). Clamp arm (182) may bepivoted away from blade (190) to release tissue from between clamp pad(184) and blade (190); and/or to perform blunt dissection of tissueengaging opposing outer surfaces of clamp arm (182) and blade (190). Insome alternative versions, inner tube (170) is translated and outer tube(152) remains stationary to provide actuation of clamp arm (182).

Reusable assembly (200) includes a pistol grip (204) in this example,though it should be understood that any other suitable kind of grip maybe used. A trigger (120) of reusable assembly (200) is configured topivot toward and away from pistol grip (204) to thereby translate outertube (152), to thereby pivot clamp arm (182). Buttons (126, 220) ofreusable assembly (200) are operable to activate blade (190) to causeblade (190) to vibrate at ultrasonic frequencies. In some versions, atleast one button (126, 220) is also operable to activate end effector(180) to deliver RF electrosurgical energy to tissue. Reusable assembly(200) also includes a battery (not shown), a generator (not shown), anultrasonic transducer assembly (not shown), and a torque wrench assembly(not shown). The battery (not shown) is operable to provide electricalpower to the generator (not shown); the generator (not shown) isoperable to provide electrical power to the ultrasonic transducerassembly (not shown); the ultrasonic transducer assembly is operable toconvert electrical power into ultrasonic vibrations; and the torquewrench assembly (not shown) is operable to mechanically and acousticallycouple waveguide (192) with the ultrasonic transducer assembly (notshown). All of these components and operabilities may be provided inaccordance with at least some of the teachings of U.S. patentapplication Ser. No. 14/868,574, entitled “Ultrasonic SurgicalInstrument with Removable Handle Assembly,” filed Sep. 29, 2015, thedisclosure of which is incorporated by reference herein.

When waveguide (192) is sufficiently coupled with the transducerassembly (not shown), ultrasonic vibrations that are generated by thetransducer assembly (not shown) are communicated along waveguide (192)to reach blade (190). In the present example, the distal end of blade(190) is located at a position corresponding to an anti-node associatedwith resonant ultrasonic vibrations communicated through waveguide(192), in order to tune the acoustic assembly to a preferred resonantfrequency f₀ when the acoustic assembly is not loaded by tissue. Whenthe transducer assembly (not shown) is energized, the distal end ofblade (190) is configured to move longitudinally in the range of, forexample, approximately 10 to 500 microns peak-to-peak, and in someinstances in the range of about 20 to about 200 microns at apredetermined vibratory frequency f₀ of, for example, 55.5 kHz. When thetransducer assembly (not shown) of the present example is activated,these mechanical oscillations are transmitted through waveguide (192) toreach blade (190), thereby providing oscillation of blade (190) at theresonant ultrasonic frequency. Thus, when tissue is secured betweenblade (190) and clamp pad (184), the ultrasonic oscillation of blade(190) may simultaneously sever the tissue and denature the proteins inadjacent tissue cells, thereby providing a coagulative effect withrelatively little thermal spread. In some versions, an electricalcurrent may also be provided through blade (190) and/or clamp pad (184)to also seal the tissue.

Other aspects of disposable assembly (100) and reusable assembly (200)may be provided in accordance with at least some of the teachings ofU.S. patent application Ser. No. 14/868,574 and/or any of the otherreferences that are cited herein. Further exemplary features andoperabilities for disposable assembly (100) and reusable assembly (200)will be described in greater detail below, while other variations willbe apparent to those of ordinary skill in the art in view of theteachings herein.

II. Exemplary Alternative Clamp Arm Attachment Features

Some operators may use blade (190) to perform back-cutting operations,where the underside of blade (190) is pressed against tissue to severthe tissue without using clamp arm (182) to compress the tissue. Theresulting lateral forces on blade (190) may cause blade (190) and/orwaveguide (192) to deflect slightly laterally. This may present a riskof blade (190) contacting pin (188), which may be undesirable. It maytherefore be desirable to reconfigure end effector (180) such that pin(188) is not laterally adjacent to blade (190). In addition to reducingmetal-to-metal contact risks associated with back-cutting, reconfiguringpin (188) may also facilitate longitudinal translation of blade (190)and waveguide (192) relative to the rest of shaft assembly (150) and endeffector (180), such as when an operator wishes to clean or replaceblade (190) and waveguide (192).

Those of ordinary skill in the art will also recognize that a clamp pad(184) may tend to wear after use, such that it may be desirable toreplace clamp pad (184). To accomplish this, it may be beneficial toremove clamp arm (182) from tubes (152, 170). In the configuration ofend effector (180), some operators may have difficulty removing pin(188) in order to enable removal of clamp arm (182) from tubes (152,170). It may therefore be desirable to reconfigure end effector (180) tomake it easier to remove clamp arm (182) from tubes (152, 170), such asby modifying the configuration of pin (188).

The examples below relate to various alternative configurations that maybe incorporated into end effector (180). At least some of thesealternative configurations may reduce metal-to-metal contact risksassociated with back-cutting, facilitate longitudinal translation ofblade (190) and waveguide (192) relative to the rest of shaft assembly(150) and end effector (180), and/or facilitate removal of clamp arm(182) from tubes (152, 170). In addition or in the alternative, thebelow described alternative configurations may provide other benefits.It should be understood that the following examples are merelyillustrative.

A. Permanent Retention Clip

FIGS. 8A-9 show an alternative shaft assembly (250) and alternative endeffector (280) that may be readily incorporated into instrument (10)described above in place of shaft assembly (150) end effector (180). Endeffector (280) includes a clamp arm (282) and a clamp pad (284) that aresubstantially similar to clamp arm (182) and clamp pad (184) describedabove, with differences described in detail below. As best seen in FIG.9, shaft assembly (250) includes an outer tube (252), an inner tube(270), and an acoustic waveguide (292) extending through both outer tube(252) and inner tube (270). Outer tube (252), inner tube (270), andacoustic waveguide (292) are substantially similar to outer tube (152),inner tube (170), and acoustic waveguide (192) mentioned above,respectively, with differences described below.

As best seen in FIGS. 8A-8B, outer tube (252) is operable to translatelongitudinally relative to inner tube (270) to selectively pivot clamparm (282) toward and away from blade (290). To accomplish this, and asbest seen in FIG. 9, integral pin features (286) of clamp arm (282),which are substantially similar to integral pin features (186) mentionedabove, pivotally secure a first portion of clamp arm (282) to pin slot(256) of a distally projecting tongue (254) of outer tube (252); whileintegral pin features (288) pivotally secure a second portion of clamparm (282) to angled distal prongs (272) of inner tube (270) via pinholes (276). It should be understood that integral pin features (286)may vertically translate within pin slot (256). Therefore, longitudinaltranslation of outer tube (252) rotates the first portion of clamp arm(282) about the second portion of clamp arm (282). Thus, as can be seenin the transition from FIG. 8A to FIG. 8B, tubes (252, 270) cooperate topivot clamp arm (282) toward blade (290) when outer tube (252) isretracted proximally relative to inner tube (270). It should beunderstood that clamp arm (282) may be pivoted back away from blade(290) (e.g., from the position shown in FIG. 8B to the position shown inFIG. 8A) by translating outer tube (252) distally relative to inner tube(270), in reverse of the operation shown in FIGS. 8A-8B. In an exemplaryuse, clamp arm (282) may be pivoted toward blade (290) to grasp,compress, seal, and sever tissue captured between clamp pad (282) andblade (290). Clamp arm (282) may be pivoted away from blade (290) torelease tissue from between clamp pad (282) and blade (290); and/or toperform blunt dissection of tissue engaging opposing outer surface ofclamp arm (282) and blade (290).

While inner tube (170) includes distally projecting tongue (172), innertube (270) of the present example includes a pair of angled distalprongs (272) defining a longitudinal channel (274). Angled distal prongs(272) each have a flat surface (278) extending from prongs (272).Together, each angled distal prong (272) and corresponding flat surface(278) define a pin hole (276). As will be described in greater detailbelow, pin holes (276) are dimensioned to receive integral pins (288) ofclamp arm (282). As also seen in FIG. 9, end effector (280) furtherincludes a cap (260). Cap (260) includes a spacer (262) and a pair offlanges (264). Spacer (262) is dimensioned with fit within longitudinalchannel (274) while flanges (264) are dimensioned to rest on top ofangled distal prongs (272). As will be described in further detailbelow, cap (260) is configured to fix integral pins (288) within pinholes (276) once clamp arm (282) is assembled to inner tube (270).

FIGS. 10A-10E show an exemplary assembly of clamp arm (282) and innertube (270). As best seen in FIG. 10A, clamp arm (282) is placed overangled distal prongs (272) such that integral pins (288) are laterallyaligned with angled distal prongs (272). It should be understood thatinner tube (270) is made out of a resilient material, such that angleddistal prongs (272) may flex relative to one another within longitudinalchannel (274). Therefore, as seen in FIG. 10B, a user may pinch angleddistal prongs (272) or flats (278) together, such that angled distalprongs (272) flex toward each other within longitudinal channel (274).Integral pins (288) and angled distal prongs (272) are then no longerlaterally aligned, but both angled distal prongs (272) are laterallybetween integral pins (288).

With angled distal prongs (272) deflected inwardly, and as seen in FIG.10C, the operator may place clamp arm (282) over inner tube (270) suchthat integral pins (288) slide past angled distal prongs (272) withinpin holes (276). Integral pins (288) abut against flats (278). At thisstage, integral pins (288) are within pin holes (276). As seen in FIG.10D, the operator may now release angled distal prongs (272) and/orflats (278). Due to the resilient nature of angled distal prongs (272)and flats (278), both angled distal prongs (272) and flats (278) returnto their natural position, as shown in FIG. 10D. Additionally, integralpins (288) abut against both angled distal prongs (272) and flats (278).Integral pins (288) are now fixed within pin holes (276) at this stage.

With integral pins (288) located in pin holes (276), and as shown inFIG. 10E, cap (260) is then placed on top of inner tube (270) such thatspacer (262) lies within longitudinal channel (274) while abuttingagainst both angled distal prongs (272). Additionally, flanges (264)rest on top angled distal prongs (272). With cap (260) in place, angleddistal prongs (272) and/or flats (278) are no longer capable ofdeflecting inwardly toward one another within longitudinal channel (274)to release integral pins (288) from pin holes (276). At this point, cap(260) may be welded to angled distal prongs (272) to fix cap (260) toinner tube (270), and therefore fix clamp arm (282) to inner tube (270).Of course, any other suitable method of fixing cap (260) to angleddistal prongs (272) may be used as would be apparent to one havingordinary skill in the art in view of the teachings herein. It should beunderstood that integral pins (288) do not extend laterally across thewidth of inner tube (270). Additionally, integral pins (288) aredimensioned to not extend across the lateral width of blade (290).Therefore, the chances of blade (290) making contact with integral pins(288) are reduced or eliminated.

While an operator flexes angled distal prongs (272) and/or flats (278)toward one another as a separate step of the process in the presentexample, it should be understood that this is merely optional. In somealternative versions, the operator may force integral pins (288) on topof angled distal prongs (272), and contact between integral pins (288)and angled distal prongs (272) may provide a camming action that flexesdistal prongs (272) and flats (278) toward each other. In some suchversions, integral pins (288) may have angled surfaces that cooperatewith angled distal prongs (272) to further promote this camming action.Other ways that angled distal prongs (273) and flats (278) may flextoward each other to create the appropriate gap for insertion ofintegral pins (288) into pin holes (276) will be apparent to one havingordinary skill in the art in view of the teachings herein.

B. Permanent Retention Tab

FIGS. 11A-11B show another alternative shaft assembly (350) andalternative end effector (380) that may be readily incorporated intoinstrument (10) described above in place of shaft assembly (150) endeffector (180). End effector (380) includes a clamp arm (382) and clamppad (384) that are substantially similar to clamp arm (182) and clamppad (184) described above, with difference described in detail below.Shaft assembly (350) includes an outer tube (352), an inner tube (370),and an acoustic waveguide (392) extending through both outer tube (352)and inner tube (370). Outer tube (252), inner tube (270), and acousticwaveguide (292) are substantially similar to outer tube (152), innertube (170), and acoustic waveguide (192) mentioned above, respectively,with differences described below.

As best seen in FIGS. 11A-11B, outer tube (352) is operable to translatelongitudinally relative to inner tube (370) to selectively pivot clamparm (382) toward and away from blade (390). To accomplish this, integralpin features (386) of clamp arm (382), which are substantially similarto integral pin features (186) mentioned above, pivotally secure a firstportion of clamp arm (382) to pin slot (356) of a distally projectingtongue (354) of outer tube (352); while integral pin features (388)pivotally secure a second portion of clamp arm (382) to angled distalprongs (372) of inner tube (370) via pin holes (376). It should beunderstood that integral pin features (386) may vertically translatewithin pin slot (356). Therefore, longitudinal translation of outer tube(352) rotates the first portion of clamp arm (382) about the secondportion of clamp arm (382). Thus, as can be seen in the transition fromFIG. 11A to FIG. 11B, tubes (352, 370) cooperate to pivot clamp arm(382) toward blade (390) when outer tube (352) is retracted proximallyrelative to inner tube (370). It should be understood that clamp arm(382) may be pivoted back away from blade (390) (e.g., from the positionshown in FIG. 11B to the position shown in FIG. 11A) by translatingouter tube (352) distally relative to inner tube (370), in reverse ofthe operation shown in FIGS. 11A-11B. In an exemplary use, clamp arm(382) may be pivoted toward blade (390) to grasp, compress, seal, andsever tissue captured between clamp pad (382) and blade (390). Clamp arm(382) may be pivoted away from blade (390) to release tissue frombetween clamp pad (382) and blade (390); and/or to perform bluntdissection of tissue engaging opposing outer surface of clamp arm (382)and blade (390).

While inner tube (170) includes distally projecting tongue (172), innertube (370) of the present example includes a pair of angled distalprongs (372) defining a longitudinal channel (374). Angled distal prongs(372) each have a flat surface (378) extending from prongs (372).Together, each angled distal prong (372) and corresponding flat surface(378) define a pin hole (376). As will be described in greater detailbelow, pin holes (376) are dimensioned to receive integral pins (388) ofclamp arm (382). As also seen in FIGS. 11A-12E, a tab (360) isintegrally fixed on one angled distal prong (372), and extends acrosslongitudinal channel (375) above the other angled distal prong (372).

FIGS. 12A-12E show an exemplary assembly of clamp arm (382) and innertube (370). FIG. 12A shows shaft assembly (350) and end effector (380)without clamp arm (382) attached. Similar to clamp arm (282) in FIG.10A, clamp arm (382) may be placed over angled distal prongs (372) suchthat integral pins (388) are laterally aligned with angled distal prongs(372). It should be understood that inner tube (370) is made out of aresilient material, such that angled distal prongs (372) may flexrelative to one another within longitudinal channel (374). Therefore, asseen in FIG. 12B, an operator may pinch angled distal prongs (372) orflats (378) together, such that angled distal prongs (372) flex towardeach other within longitudinal channel (374). As seen in FIG. 12C,angled distal prongs (372) are then spaced such that integral pins (388)may slide within pin holes (376) and abut against the portion of pinholes (376) defined by flats (378). At this stage, integral pins (388)are within pin holes (376).

With integral pins (388) are within pin holes (376), and as seen in FIG.12D, the operator may now release angled distal prongs (372) and/orflats (378). Due to the resilient nature of angled distal prongs (372)and flats (378), both angled distal prongs (372) and flats (378) returnto their natural position, as shown in FIG. 12D. Additionally, integralpins (388) abut against both angled distal prongs (372) and flats (378).Integral pins (388) are now fixed within pin holes (376) at this stage.With pins (388) fixed within pin holes (376), and as shown in FIG. 12E,the operator may fix or secure tab (360) to the other angled distalprong (372) that tab (360) is not already integrally fixed to. End (362)of tab (360) may be fixed to the other angled distal prong (372) throughwelding or any other suitable method known to one having ordinary skillin the art in view of the teachings herein. With tab (360) fixed to bothangled distal prongs (372), angled distal prongs (372) and/or flats(378) are no longer capable of deflecting inwardly toward one another torelease integral pins (388) from pin holes (376). It should beunderstood that integral pins (388) do not extend laterally across thewidth of inner tube (370). Additionally, integral pins (388) aredimensioned to not extend across the lateral width of blade (390).Therefore, chances of blade (390) making contact with integral pins(388) are reduced or eliminated.

While in the current example, a user flexes angled distal prongs (372)and/or flats (378) towards one another in the present example, it shouldbe understood that this is merely optional. In some alternativeversions, the operator may force integral pins (388) on top of angleddistal prongs (372), and contact between integral pins (388) and angleddistal prongs (372) may provide a camming action that flexes angleddistal prongs (372) and flats (378) toward each other. In some suchversions, integral pins (388) may have angled surfaces that cooperatewith angled distal prongs (372) to further promote this camming action.Other ways that angled distal prongs (373) and flats (378) may flextoward each other to create the appropriate gap for insertion ofintegral pins (388) into pin holes (376) will be apparent to one havingordinary skill in the art in view of the teachings herein.

C. Removable Retention Cap

FIGS. 13A-14C show another alternative shaft assembly (450) andalternative end effector (480) that may be readily incorporated intoinstrument (10) described above in place of shaft assembly (150) endeffector (180). End effector (480) includes a clamp arm (482) and clamppad (484) that are substantially similar to clamp arm (282) and clamppad (284) described above, with difference described in detail below. Asbest seen in FIG. 14A, shaft assembly (450) includes an outer tube(452), an inner tube (470), and an acoustic waveguide (492) extendingthrough both outer tube (452) and inner tube (470). Outer tube (452),inner tube (470), and acoustic waveguide (492) are substantially similarto outer tube (252), inner tube (270), and acoustic waveguide (292)mentioned above, respectively, with differences described below.

As best seen in FIGS. 13A-13B, outer tube (452) is operable to translatelongitudinally relative to inner tube (470) to selectively pivot clamparm (482) toward and away from blade (490). To accomplish this, integralpin features (486) of clamp arm (482), which are substantially similarto integral pin features (286) mentioned above, pivotally secure a firstportion of clamp arm (482) to pin slot (456) of a distally projectingtongue (454) of outer tube (452); while integral pin features (488)pivotally secure a second portion of clamp arm (482) to angled distalprongs (472) of inner tube (470) via pin holes (476). It should beunderstood that integral pin features (486) may vertically translatewithin pin slot (456). Therefore, longitudinal translation of outer tube(452) rotates the first portion of clamp arm (482) about the secondportion of clamp arm (482). Thus, as can be seen in the transition fromFIG. 13A to FIG. 13B, tubes (452, 470) cooperate to pivot clamp arm(482) toward blade (490) when outer tube (452) is retracted proximallyrelative to inner tube (470). It should be understood that clamp arm(482) may be pivoted back away from blade (490) (e.g., from the positionshown in FIG. 13B to the position shown in FIG. 13A) by translatingouter tube (452) distally relative to inner tube (470), in reverse ofthe operation shown in FIGS. 13A-13B. In an exemplary use, clamp arm(482) may be pivoted toward blade (490) to grasp, compress, seal, andsever tissue captured between clamp pad (482) and blade (490). Clamp arm(482) may be pivoted away from blade (490) to release tissue frombetween clamp pad (482) and blade (490); and/or to perform bluntdissection of tissue engaging opposing outer surface of clamp arm (482)and blade (490).

Similar to inner tube (270), inner tube (470) of the present exampleincludes a pair of angled distal prongs (472) defining a longitudinalchannel (474). Angled distal prongs (472) each have a flat surface (478)extending from prongs (472). Together, each angled distal prong (472)and corresponding flat surface (478) define a pin hole (476). Clamp arm(482) may be attached to inner tube (470) in substantially the samemanner as described above for coupling clamp arm (282) with inner tube(270), with the difference of inserting removable cap (460) as will bedescribe below. It should therefore be understood that inner tube (470)is made out of a resilient material, such that angled distal prongs(472) may flex relative to one another within longitudinal channel(474). Pin holes (476) are dimensioned to receive integral pins (488) ofclamp arm (482) when angled distal prongs (472) and flats (478) areflexed toward each other within longitudinal channel (474). Withintegral pins (488) inserted into pin holes (476), angled distal prongs(472) and flats (478) may return to their natural position such thatintegral pins (488) abut against portions of angled distal prongs (472)and flats (478) defining pin holes (476).

When pins (488) are disposed in corresponding pin holes (476), and asbest seen in FIGS. 14A-14C, removable cap (460) may be inserted intolongitudinal channel (474) to prevent angled distal prongs (472) and/orflats (478) from deflecting inwardly toward one another to releaseintegral pins (488) from pin holes (476). Removable cap (460) includes aspacer portion (462), a resilient portion (464) extending from spacerportion (462), and a tab (466) extending from resilient portion (464).Additionally, longitudinal channel (474) includes an access channel(473) and a locking channel (475). Access channel (473) is sized so anoperator may insert an object or their finger within access channel(473) to selectively remove removable cap (460) by sliding removable cap(460) distally. Locking channel (475) is sized to receive tab (466) whenremovable cap (460) is fully inserted, thereby longitudinally lockingremovable cap (460) relative to inner tube (470).

Spacer portion (462) defines a pair of longitudinal slots (468).Longitudinal slots (468) are sized to receive the inner edges of angleddistal prongs (472) when removable cap (460) is installed. As best seenin FIGS. 14A-14B, the operator may vertically align longitudinal slots(468) with the edges of angled distal prongs (472) so that longitudinalslots (468) house the edges of angled distal prongs (472). Resilientmember is capable of bending, such that tab (466) may vertically moverelative to spacer portion (462). Thus, as shown in FIG. 14B, whenspacer portion (468) initially engages angled distal prongs (472), tab(466) may slide on top of longitudinal channel (474) and angled distalprongs (472).

As best seen in FIG. 14C, when spacer portion (462) slides a sufficientdistance proximally toward inner tube (470), tab (466) may fit withinlocking channel (475). With tab (466) no longer forced abovelongitudinal channel (464) through engagement with angled distal prongs(472), the resilient nature of resilient portion (464) moves tab (466)within locking channel (475). Tab (466) is thereby vertically alignedwith spacer portion (462) at this stage. As described above, spacerportion (462) is located between angled distal prongs (472) such thatangled distal prongs (472) and/or flats (478) are no longer capable ofdeflecting inwardly toward one another to release integral pins (488)from pin holes (476). Additionally, tab (466) resting within lockingchannel (475) prevents unintentional longitudinal movement of removablecap (460) relative to inner tube (470). If an operator desires to removeremovable cap (460) (e.g. to remove clamp arm (482)), the operator maypush tab (466) downwardly so tab (466) no longer engages locking channel(475), then slide removable cap (460) in the distal direction.Alternatively, an operator user may insert an object or their fingerinto access channel (473) in order to lift tab (466) above lockingchannel (475), then slide removable cap (460) in the distal direction.

III. Exemplary Locking and Location Features for a Removable Blade

In some instances, ultrasonic blade (190, 290, 390, 490) and waveguide(192, 292, 392, 492) may be removable from the rest of shaft assembly(150, 250, 350, 450) and end effector (180, 280, 380, 480). This mayenable cleaning and/or other processing of ultrasonic blade (190, 290,390, 490) and waveguide (192, 292, 392, 492). In such cases, it may bedesirable to have a locking and locating feature associated withinstrument (10) such that ultrasonic blade (190, 290, 390, 490) andwaveguide (192, 292, 393, 492) are oriented in the same angular positionrelative to shaft assembly (150, 250, 350, 450) and end effector (180,280, 380, 480) every time a user reassembles ultrasonic blade (190, 290,390, 490) and waveguide (192, 292, 392, 492) within end effector (180,280, 380, 480) and shaft assembly (150, 250, 350, 450). This consistencyin the angular orientation of ultrasonic blade (190, 290, 390, 490) andwaveguide (192, 292, 393, 492) may be desirable in order to ensure thatthe proper region of ultrasonic blade (190, 290, 390, 490) is facingclamp pad (184, 284, 384, 484). Having consistency in the angularorientation of ultrasonic blade (190, 290, 390, 490) and waveguide (192,292, 393, 492) may also be particularly desirable in contexts whereultrasonic blade (190, 290, 390, 490) extends along a curve, to ensurethat the curve of a complimentarily curved clamp arm (182, 282, 382,482) is aligned with the curve of ultrasonic blade (190, 290, 390, 490).

The following examples provide various features that may be used toprovide consistent angular orientation of ultrasonic blade (190, 290,390, 490) as ultrasonic blade (190, 290, 390, 490) and waveguide (192,292, 393, 492) are inserted into shaft assembly (150, 250, 350, 450).Further examples are described in U.S. patent application Ser. No.14/868,574, entitled “Ultrasonic Surgical Instrument with RemovableHandle Assembly,” filed Sep. 29, 2015, the disclosure of which isincorporated by reference herein. It should be understood that theteachings below may be readily combined with any of the teachings above,such that the examples below are not intended to be exclusive of theexamples above. It should also be understood that the teachings belowmay be readily applied to other versions of instrument (10), not justthe versions of instrument (10) that are described herein.

A. Spring Loaded Key Lock

FIGS. 15A-15B show an alternative shaft assembly (550) and analternative body portion (510) that may be readily incorporated intoinstrument (10) described above. Shaft assembly (550) includes arotation assembly (540) that is operable to rotate shaft assembly (550)relative to body portion (510). Rotation assembly (540) includes arotation knob (542) unitarily attached to a sleeve (544) extending intobody portion (510). Shaft assembly further includes an outer tube (552),an inner tube (570), and a waveguide (592) extending through inner tube(570) and outer tube (552). Outer tube (552), inner tube (570) andwaveguide (592) are substantially similar to outer tube (152), innertube (170), and waveguide (192) described above, respectively, withdifferences described below. As best seen in FIGS. 15A-15B, a portion ofouter tube (552), inner tube (570) and waveguide (592) extend throughrotation knob (542) and sleeve (544).

Body portion (510) also houses a spring loaded key lock assembly (520).As will be described in greater detail below, spring loaded key lockassembly (520) is capable of selectively locking the longitudinalposition of waveguide (592) relative to inner tube (570). Additionally,as will be described in greater detail below, spring loaded key lockassembly (520) is also capable of unlocking waveguide (592) relative toinner tube (570) and outer tube (552), such that waveguide (592) may beremoved from body portion (510) for cleaning or other reasons.

Spring loaded key lock (520) includes a handle (524) that is connectedto a pair of locking forks (522). Lock (520) further includes a biasingmember (526) that is fixed to sleeve (544) of rotation assembly (540)and handle (524). Locking forks (522) extend from handle (524) towardsleeve (544). As best seen in FIG. 15A, biasing member (526) biaseshandle (524) toward sleeve (544). However, as best seen in FIG. 15B, anoperator may pull handle (524) away from sleeve (544) to stretch biasingmember (526). However, as soon as a user releases handle (524), biasingmember (526) will resiliently actuate handle (525) toward sleeve (544).

As can be seen in FIGS. 16A-16B, sleeve (544), outer tube (552), andinner tube (570) define a pair of key slots (528) that are dimensionedto receive locking forks (522). Locking forks (522) may also actuatewithin key slots (528). Additionally, waveguide (592) defines a pair ofkeyed flats (594) and a pair of faces (595). Faces (595) are adjacentand perpendicular to keyed flats (594). As best seen in FIGS. 15A-15B,keyed flats (594) are dimensioned with a substantially similar, if notexact, width of locking forks (522). Therefore, when key lock assembly(520) engages waveguide (592), faces (595) prevent waveguide (592) fromtraveling in the longitudinal direction due to interaction of faces(595) and locking forks (522). Additionally, as best seen in FIG. 16A,locking forks (522) are spaced apart from one another so that eachlocking fork (522) makes contact with its respective keyed flat (594)when locking forks (522) are located within keyed slots (528).Therefore, keyed flats (594) prevent waveguide (592) from lateralmovement or rotating about its own longitudinal axis due to interactionof keyed flats (594) and locking forks (522).

Additionally, as best seen in FIG. 15B and FIG. 16B, an operator maypull handle (524) away from sleeve (544) so that locking forks (522)travel along key slots (528). Locking forks (522) may travel along keyslots (528) until locking forks (522) no longer make contact with faces(595) or keyed flats (594). An operator may thus pull waveguide (592) inthe proximal direction until waveguide (592) is sufficiently removedfrom inner tube (570) and outer tube (552). If the operator desires toplace waveguide (592) back into inner tube (570) and outer tube (552),the operator may pull handle (524) away from sleeve (544), insertwaveguide (592) into inner tube (570) and outer tube (552) until lockingforks (522) align with keyed flats (594), and then allow biasing member(526) to force locking forks (522) within key slots (528).

B. Inner and Outer Tube with Orientation Features

FIGS. 17-18C show another alternative shaft assembly (650) that may bereadily incorporated into instrument (10) described above. Shaftassembly (650) includes an ultrasonic waveguide (692), an inner tube(670), an outer tube (652), and a rotation assembly (640); which aresubstantially similar to ultrasonic waveguide (192), inner tube (170),outer tube (152), and rotation assembly (540), respectively, except forthe differences described below.

As best seen in FIG. 17, ultrasonic waveguide (692) includes a seal(696), a cam pin (694) and a threaded stud (698) that is configured tocouple with an ultrasonic transducer (not shown). Inner tube (670)includes a cam slot (672) extending from the proximal end of inner tube(670) and terminating at a placement hole (674). Outer tube (652)includes a cam slot (654) extending from the proximal end of outer tube(652) and terminating in a translation slot (656). Rotation assembly(640) includes a rotation knob (642) defining a channel (646) and alocking feature (644). Locking feature (644) may actuate relative to therest of rotation assembly (640). It should be understood that cam pin(694) may fit within both cam slots (672, 654) and radially extend fromthe rest of ultrasonic waveguide (692) as to extend beyond thedimensions of inner tube (670) and outer tube (652).

FIGS. 18A-18C show how waveguide (692) may be assembled within outertube (652), inner tube (670), and rotation knob (642). Outer tube (652)and inner tube (670) are partially disposed within channel (646) ofrotation knob (642). An operator may insert the distal end of waveguide(692) into the proximal openings of inner tube (670) and outer tube(552) such that cam pin (694) is aligned with cam slots (672, 654). Asmentioned above, camp pin (694) extends radially outwardly from the restof ultrasonic waveguide (692) such that cam pin (694) extends beyond thedimensions of inner tube (670) and outer tube (652). Therefore, when campin (694) is aligned with cam slots (672, 654), cam pin (694) extendsthrough inner tube (670) and outer tube (652) via cam slots (672, 654).It should be understood that cam slots (672, 654) are aligned when outertube (652) is actuated to its most distal position relative to innertube (670). However, cam slots (672, 654) may be dimensioned to align atany other longitudinal location of outer tube (652) relative to innertube (670) as would be apparent to one having ordinary skill in the artin view of the teachings herein.

As shown in FIG. 18B, the operator push ultrasonic waveguide (692) inthe distal direction. As waveguide (692) travels distally, cam slots(672, 654) force waveguide (692) to rotate via cam pin (694). Waveguide(692) may travel distally within inner tube (670) and outer tube (652)until cam pin (694) reaches placement hole (674) as shown in FIG. 18B.Because cam pin (694) is located at the same location relative to therest of waveguide (692), and because cam slots (672, 654) are located atthe same location when aligned, waveguide (692) will uniformly locate inthe same longitudinal and rotational position every time waveguide (692)is inserted into inner tube (670) and outer tube (652). Placement hole(674) is located directly adjacent to locking feature (644). Asdescribed above, locking feature (644) is capable of actuating relativeto the rest of rotation assembly (640). Additionally, locking feature(644) is dimensioned for a snap fit with cam pin (694) when lockingfeature (644) is actuated toward cam pin (694) as shown in FIG. 18C.Waveguide (692) is thereby rotationally and longitudinally fixedrelative to rotation assembly (640). While locking feature (644) uses asnap fit to lock with cam pin (694) in the current example, any othersuitable method of fixing cam pin (694) to locking feature (644) may beutilized as would be apparent to one having ordinary skill in the art inview of the teachings herein.

If an operator wishes to remove waveguide (692) for cleaning or otherpurposes, the operator may actuate locking feature (644) in the upwarddirection so that locking feature (644) is no longer fixed to cam pin(694). The operator may then pull waveguide (692) in the proximaldirection to further remove waveguide (692) from inner tube (670) andouter tube (652)

It should be understood that translation slot (656) of outer tube (652)is dimensioned to allow outer tube (652) to longitudinally travelrelative to inner tube (670) such that outer tube (652) does notinterfere with cam pin (694) when waveguide (692) is assembled in placeand secured by locking feature (644). Therefore, the operator may stillopen and close a clamp arm relative to a blade. It should also beunderstood that while one cam pin (694) and one pair of cam slots (672,654) are utilized in the current example, any suitable number of campins (694) and cam slots (672, 654) may be utilized.

C. Waveguide with Clocking Pin

FIG. 19 shows an ultrasonic blade (792) and body portion (710) that maybe readily incorporated into instrument (10) described above. As bestseen in FIGS. 26A-26C, body portion (710) includes a shroud (712)defining a pair of rotating recesses (714). As will be described ingreater detail below, rotating recesses (714) of shroud (712) areconfigured to rotationally and longitudinally align ultrasonic blade(792) relative to the rest of body portion (710).

As best seen in FIGS. 20-24, waveguide (792) includes a threaded recess(798) that is configured to couple waveguide (792) with an ultrasonictransducer (not shown), a silicone portion (794) defining a pin hole(796), and a clocking pin (780) that is configured to fit within pinhole (796) of silicone portion (794). Clocking pin (780) includes a pin(786) surrounded by a silicone overmold (788). Clocking pin (780)further includes a pair of clocking blocks (784) located at the ends ofpin (786). Clocking blocks (784) may be made out of a plastic materialor contain a plastic overmold. Silicone portion (794) and siliconeovermold (788) help isolate ultrasonic waveguide (792) from clocking pin(780). This may help prevent clocking pin (780) from transmittingacoustic vibrations that are transmitted through waveguide (792) to anultrasonic blade. Clocking pin (780) fits within pin hole (796) in sucha way that clocking pin (780) is fixed relative to ultrasonic waveguide(792).

FIGS. 25A-26C show an exemplary assembly of waveguide (792). First, asshown in FIG. 25A and FIG. 26A, the proximal end of ultrasonic waveguide(792) is inserted into the distal end of shroud (712). Clocking blocks(784) of clocking pin (780) are thereby inserted into the origin ofrotating recesses (714). Rotating recesses (714) define respectivehelical paths within shroud (712). Therefore, as shown in FIG. 25B andFIG. 26B, as waveguide (792) is rotated, clocking blocks (784), andtherefore waveguide (792), travel proximally within shroud (712) whilerotating to a predetermined angular orientation. Eventually, as shown inFIG. 25C and FIG. 26C, clocking blocks (784) reach the termination ofrotating recesses (714). At this point, waveguide (792) cannot furtherrotate or travel proximally relative to shroud (712). Because shroud(712) is fixed relative to the rest of body (710), waveguide (792) willbe uniformly placed in the same longitudinal and angular position everytime waveguide (792) is “clocked” within shroud (712). An operator mayremove waveguide (792) for cleaning and reinsert waveguide (792) backinto shroud (712) at the exact location for subsequent use.

While the present example has waveguide (792) being inserted at thedistal end of shroud (712), alternatively waveguide (792) may also beconfigured to be inserted in the proximal end of shroud (712).

D. Tethered Waveguide

FIGS. 27A-27B show an alternative body (810), shaft assembly (850), andend effector (880) that may be readily incorporated into instrument (10)described above. Shaft assembly (850) and end effector (880) aresubstantially similar to shaft assembly (150) and end effector (180)described above, with differences described below. Shaft assembly (850)includes an outer tube (852), an inner tube (not shown), a waveguide(892) and a rotation assembly (840); which are substantially similar toouter tube (152), inner tube (170), waveguide (192) and rotationassembly (540) described above. Rotation assembly (840) includes arotation knob (842) substantially similar to rotation knob (542)described above. Waveguide (892) defines a pin hole (891) that isconfigured to be used in coupling waveguide (892) to body (810). Endeffector (880) includes a clamp arm (882) and an acoustic blade (890)substantially similar to clamp arm (182) and acoustic blade (190)mentioned above.

Body (810) includes a trigger (820), a tether (894) connected towaveguide (892) at a connection point (898), and a tether housing (812)that stores a coiled portion (896) of tether (894). Tether (894) extendsfrom coiled portion (896) in such a way that portions of tether (894)may extend out of coiled portion (896), as shown in FIG. 27B. Coiledportion (896) may have recoil function, such that tugging on the portionof tether (894) extending from coiled portion (896) encourages coiledportion (896) to recoil excess lengths of tether (894). As shown in FIG.27B, connection point (898) couples tether (894) with waveguide (892)such that waveguide (892) can be removed relative to the rest of shaftassembly (850), but cannot be removed entirely relative to body (810).In other words, even if waveguide (892) is removed from shaft assembly(850) for cleaning, waveguide (892) cannot be completely detached frombody (810) due to tether (894). Connection point (898) may consist of agroove on waveguide (892) in which tether (894) is tied around.Alternatively, connection point (898) may comprise an overmold ofsilicone on the portion of tether (894) in contact with waveguide (892).Various other suitable ways in which tether (894) may be secured towaveguide (892) will be apparent to one having ordinary skill in the artin view of the teachings herein.

IV. Exemplary Combinations

The following examples relate to various non-exhaustive ways in whichthe teachings herein may be combined or applied. It should be understoodthat the following examples are not intended to restrict the coverage ofany claims that may be presented at any time in this application or insubsequent filings of this application. No disclaimer is intended. Thefollowing examples are being provided for nothing more than merelyillustrative purposes. It is contemplated that the various teachingsherein may be arranged and applied in numerous other ways. It is alsocontemplated that some variations may omit certain features referred toin the below examples. Therefore, none of the aspects or featuresreferred to below should be deemed critical unless otherwise explicitlyindicated as such at a later date by the inventors or by a successor ininterest to the inventors. If any claims are presented in thisapplication or in subsequent filings related to this application thatinclude additional features beyond those referred to below, thoseadditional features shall not be presumed to have been added for anyreason relating to patentability.

Example 1

An apparatus comprising: (a) a shaft assembly defining a longitudinalaxis, wherein the shaft assembly comprises: (i) a first coupling member,and (ii) a second coupling member, wherein the first coupling member andthe second coupling member are configured to flex toward each other froma first position to a second position, wherein the first coupling memberand the second coupling member define a pivot axis in the firstposition; and (b) an end effector comprising: (i) an ultrasonic bladeextending from the shaft assembly, (ii) a lamp arm configured to coupleor decouple with the shaft assembly when the first coupling member andthe second coupling member are in the second position, wherein the clamparm is configured to pivot toward and away the ultrasonic blade aboutthe pivot axis when the first coupling member and the second couplingmember are in the first position.

Example 2

The apparatus of Example 1, wherein the clamp arm comprises a firstintegral pin and a second integral pin, wherein the first integral pinis configured to couple or decouple with the first coupling member whenthe first coupling member and the second coupling member are in thesecond position, wherein the second integral pin is configured to coupleor decouple with the second coupling member when the first couplingmember and the second coupling member are in the second position.

Example 3

The apparatus of Example 2, wherein the first integral pin and thesecond integral pin define a lateral gap, wherein the width of theultrasonic blade is smaller than the lateral gap.

Example 4

The apparatus of any one or more of Examples 1 through 3, wherein thefirst coupling member and the second coupling member define alongitudinal channel, wherein the longitudinal channel is wider in thefirst position than the second position.

Example 5

The apparatus of Example 4, wherein the first coupling member comprisesa tab, wherein the tab extends over the longitudinal channel toward thesecond coupling member.

Example 6

The apparatus of Example 5, wherein the tab is configured to be fixed tothe second coupling member, wherein the tab is configured to prevent thefirst coupling member and the second coupling member from flexing to thesecond position when the tab is fixed to the second coupling member.

Example 7

The apparatus of any one or more of Examples 4 through 6, wherein theshaft assembly further comprises a cap.

Example 8

The apparatus of Example 7, wherein the cap comprises a spacer, whereinthe spacer is dimensioned to fit within the longitudinal channel whenthe first coupling member and the second coupling member are in thefirst position.

Example 9

The apparatus of Example 8, wherein the spacer is configured to preventthe first coupling member and the second coupling member from flexingfrom the first position to the second position when the spacer is withinthe longitudinal channel.

Example 10

The apparatus of Example 9, wherein the cap comprises a first flange anda second flange, wherein the first flange is configured to rest on topof the first coupling member, wherein the second flange is configured torest on top of the second coupling member.

Example 11

The apparatus of Example 10, wherein the first flange is configured tofix to the first coupling member, wherein the second flange isconfigured to fix to the second coupling member.

Example 12

The apparatus of any one or more of Examples 9 through 11, wherein thespacer defines a first longitudinal slot and a second longitudinal slot,wherein the first longitudinal slot is configured to house a portion ofthe first coupling member, wherein the second longitudinal slot isconfigured to house a portion of the second coupling member.

Example 13

The apparatus of any one or more of Examples 9 through 12, wherein thecap further comprises a tab, wherein the first coupling member and thesecond coupling member further define a locking channel, wherein the tabis dimensioned to fit within the locking channel, wherein the tab isconfigured to prevent longitudinal movement of the cap when the tab iswithin the locking channel.

Example 14

The apparatus of Example 13, wherein the cap further comprises aresilient member positioned between the tab and the spacer.

Example 15

An apparatus comprising: (a) an end effector comprising an ultrasonicblade; and (b) a shaft assembly defining a longitudinal axis, whereinthe ultrasonic blade extends from the shaft assembly, wherein the shaftassembly comprises: (i) a first tube, (ii) an acoustic waveguideextending through the first tube, wherein the acoustic waveguide isunitarily attached to the ultrasonic blade, wherein the acousticwaveguide is configured to be removed from the first tube, and (iii) alocating feature, wherein the locating feature is configured to orientthe acoustic waveguide relative to the first tube along the longitudinalaxis and about the longitudinal axis.

Example 16

The apparatus of Example 15, wherein the locating feature comprises akey lock, wherein the acoustic waveguide defines a recess configured tomate with the key lock to orient the acoustic waveguide relative to thefirst tube.

Example 17

The apparatus of Example 16, wherein the key lock is biased to engagethe recess defined by the acoustic waveguide.

Example 18

The apparatus of any one or more of Examples 15 through 17, wherein thelocating feature comprises a cam slot defined by the first tube, whereinthe acoustic waveguide comprises a cam pin configured to be insertedinto the cam slot.

Example 19

The apparatus of Example 18, wherein the shaft assembly furthercomprises a locking feature configured to selectively fix to the campin.

Example 20

An apparatus comprising: (a) a body portion; (b) a shaft assemblyextending distally from the body portion, wherein the shaft assemblycomprises: (i) an acoustic waveguide, and (ii) a tube, wherein theacoustic waveguide is configured to fit coaxially within the tube,wherein the acoustic waveguide is configured to be removed from thetube; and (c) a tether, wherein a first end of the tether is coupledwith the body portion, wherein a second portion of the tether is coupledwith the acoustic waveguide, wherein the tether has a length configuredto enable removal of the acoustic waveguide from the tube while stillcoupling the acoustic waveguide with the body portion.

V. Miscellaneous

It should be understood that any of the versions of instrumentsdescribed herein may include various other features in addition to or inlieu of those described above. By way of example only, any of theinstruments described herein may also include one or more of the variousfeatures disclosed in any of the various references that areincorporated by reference herein. It should also be understood that theteachings herein may be readily applied to any of the instrumentsdescribed in any of the other references cited herein, such that theteachings herein may be readily combined with the teachings of any ofthe references cited herein in numerous ways. Other types of instrumentsinto which the teachings herein may be incorporated will be apparent tothose of ordinary skill in the art.

It should also be understood that any ranges of values referred toherein should be read to include the upper and lower boundaries of suchranges. For instance, a range expressed as ranging “betweenapproximately 1.0 inches and approximately 1.5 inches” should be read toinclude approximately 1.0 inches and approximately 1.5 inches, inaddition to including the values between those upper and lowerboundaries.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool withUltrasound Cauterizing and Cutting Instrument,” published Aug. 31, 2004,the disclosure of which is incorporated by reference herein.

Versions described above may be designed to be disposed of after asingle use, or they can be designed to be used multiple times. Versionsmay, in either or both cases, be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, someversions of the device may be disassembled, and any number of theparticular pieces or parts of the device may be selectively replaced orremoved in any combination. Upon cleaning and/or replacement ofparticular parts, some versions of the device may be reassembled forsubsequent use either at a reconditioning facility, or by an operatorimmediately prior to a procedure. Those skilled in the art willappreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

I/We claim:
 1. An apparatus comprising: (a) a shaft assembly defining a longitudinal axis, wherein the shaft assembly comprises: (i) a first coupling member, and (ii) a second coupling member, wherein the first coupling member and the second coupling member are configured to flex toward each other from a first position to a second position, wherein the first coupling member and the second coupling member define a pivot axis in the first position; and (b) an end effector comprising: (i) an ultrasonic blade extending from the shaft assembly, (ii) a clamp arm configured to couple or decouple with the shaft assembly when the first coupling member and the second coupling member are in the second position, wherein the clamp arm is configured to pivot toward and away the ultrasonic blade about the pivot axis when the first coupling member and the second coupling member are in the first position.
 2. The apparatus of claim 1, wherein the clamp arm comprises a first integral pin and a second integral pin, wherein the first integral pin is configured to couple or decouple with the first coupling member when the first coupling member and the second coupling member are in the second position, wherein the second integral pin is configured to couple or decouple with the second coupling member when the first coupling member and the second coupling member are in the second position.
 3. The apparatus of claim 2, wherein the first integral pin and the second integral pin define a lateral gap, wherein the width of the ultrasonic blade is smaller than the lateral gap.
 4. The apparatus of claim 1, wherein the first coupling member and the second coupling member define a longitudinal channel, wherein the longitudinal channel is wider in the first position than the second position.
 5. The apparatus of claim 4, wherein the first coupling member comprises a tab, wherein the tab extends over the longitudinal channel toward the second coupling member.
 6. The apparatus of claim 5, wherein the tab is configured to be fixed to the second coupling member, wherein the tab is configured to prevent the first coupling member and the second coupling member from flexing to the second position when the tab is fixed to the second coupling member.
 7. The apparatus of claim 4, wherein the shaft assembly further comprises a cap.
 8. The apparatus of claim 7, wherein the cap comprises a spacer, wherein the spacer is dimensioned to fit within the longitudinal channel when the first coupling member and the second coupling member are in the first position.
 9. The apparatus of claim 8, wherein the spacer is configured to prevent the first coupling member and the second coupling member from flexing from the first position to the second position when the spacer is within the longitudinal channel.
 10. The apparatus of claim 9, wherein the cap comprises a first flange and a second flange, wherein the first flange is configured to rest on top of the first coupling member, wherein the second flange is configured to rest on top of the second coupling member.
 11. The apparatus of claim 10, wherein the first flange is configured to fix to the first coupling member, wherein the second flange is configured to fix to the second coupling member.
 12. The apparatus of claim 9, wherein the spacer defines a first longitudinal slot and a second longitudinal slot, wherein the first longitudinal slot is configured to house a portion of the first coupling member, wherein the second longitudinal slot is configured to house a portion of the second coupling member.
 13. The apparatus of claim 9, wherein the cap further comprises a tab, wherein the first coupling member and the second coupling member further define a locking channel, wherein the tab is dimensioned to fit within the locking channel, wherein the tab is configured to prevent longitudinal movement of the cap when the tab is within the locking channel.
 14. The apparatus of claim 13, wherein the cap further comprises a resilient member positioned between the tab and the spacer.
 15. An apparatus comprising: (a) an end effector comprising an ultrasonic blade; and (b) a shaft assembly defining a longitudinal axis, wherein the ultrasonic blade extends from the shaft assembly, wherein the shaft assembly comprises: (i) a first tube, (ii) an acoustic waveguide extending through the first tube, wherein the acoustic waveguide is unitarily attached to the ultrasonic blade, wherein the acoustic waveguide is configured to be removed from the first tube, and (iii) a locating feature, wherein the locating feature is configured to orient the acoustic waveguide relative to the first tube along the longitudinal axis and about the longitudinal axis.
 16. The apparatus of claim 15, wherein the locating feature comprises a key lock, wherein the acoustic waveguide defines a recess configured to mate with the key lock to orient the acoustic waveguide relative to the first tube.
 17. The apparatus of claim 16, wherein the key lock is biased to engage the recess defined by the acoustic waveguide.
 18. The apparatus of claim 15, wherein the locating feature comprises a cam slot defined by the first tube, wherein the acoustic waveguide comprises a cam pin configured to be inserted into the cam slot.
 19. The apparatus of claim 18, wherein the shaft assembly further comprises a locking feature configured to selectively fix to the cam pin.
 20. An apparatus comprising: (a) a body portion; (b) a shaft assembly extending distally from the body portion, wherein the shaft assembly comprises: (i) an acoustic waveguide, and (ii) a tube, wherein the acoustic waveguide is configured to fit coaxially within the tube, wherein the acoustic waveguide is configured to be removed from the tube; and (c) a tether, wherein a first end of the tether is coupled with the body portion, wherein a second portion of the tether is coupled with the acoustic waveguide, wherein the tether has a length configured to enable removal of the acoustic waveguide from the tube while still coupling the acoustic waveguide with the body portion. 